Tuccinardi Alicia, Czuzoj-Shulman Nicholas, Abenhaim Haim A
Department of Obstetrics & Gynecology, Jewish General Hospital, McGill University, Montreal, QC, Canada.
Center for Clinical Epidemiology, Jewish General Hospital, Montreal, QC, Canada.
J Perinat Med. 2022 Mar 14;50(5):587-594. doi: 10.1515/jpm-2021-0361. Print 2022 Jun 27.
Pregnancy outcomes in women with inflammatory myopathies (IM) are not well studied. The purpose of this study is to evaluate the effects of IM on maternal and neonatal outcomes.
We conducted a retrospective cohort study using data from the Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS) from 1999 to 2015. Among all pregnant women who delivered during this period, those with a diagnosis of IM were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding, which included all patients with dermatomyositis and polymyositis. Maternal and neonatal outcomes were compared in pregnant women with and without IM. Multivariate logistic regression analysis was used to estimate the adjusted effects of IM on these outcomes.
A total of 13,792,544 pregnant women delivered between 1999 and 2015, of which 308 had a diagnosis of IM, for an overall prevalence of 2 per 100,000 pregnant women, with rates increasing over the study period. Pregnant women with IM were more likely to be older, African American and suffer from other autoimmune connective tissue diseases. IM in pregnancy was associated with greater risk of preeclampsia, caesarean delivery, major postpartum infections, urinary tract infections and longer hospital stay. Neonates born to mothers with IM had greater risk of prematurity, small for gestational age and intrauterine fetal demise.
Pregnant women with IM are at higher risk of adverse maternal and neonatal outcomes and should be closely followed in specialized centers with collaboration between maternal-fetal medicine and rheumatology.
炎症性肌病（IM）女性患者的妊娠结局尚未得到充分研究。本研究旨在评估IM对孕产妇和新生儿结局的影响。
我们利用1999年至2015年医疗成本和利用项目-全国住院患者样本（HCUP-NIS）的数据进行了一项回顾性队列研究。在这一时期分娩的所有孕妇中，使用国际疾病分类第九版临床修订本（ICD-9-CM）编码确定诊断为IM的患者，其中包括所有皮肌炎和多发性肌炎患者。比较了患有和未患有IM的孕妇的孕产妇和新生儿结局。采用多因素逻辑回归分析来估计IM对这些结局的校正影响。
1999年至2015年间共有13792544名孕妇分娩，其中308名被诊断为IM，每10万名孕妇中的总体患病率为2例，且在研究期间患病率有所上升。患有IM的孕妇更有可能年龄较大、为非裔美国人且患有其他自身免疫性结缔组织疾病。妊娠期IM与子痫前期、剖宫产、严重产后感染、尿路感染及住院时间延长的风险增加相关。IM母亲所生新生儿早产、小于胎龄及宫内胎儿死亡的风险更高。
患有IM的孕妇出现不良孕产妇和新生儿结局的风险更高，应在母胎医学和风湿病学协作的专科中心进行密切随访。
